Diseases of the heart and aorta / by Thomas E. Satterthwaite.

  • Satterthwaite, Thomas E. (Thomas Edward), 1843-1934
Date:
[1905], [©1905]
Catalogue details

Licence: Public Domain Mark

Credit: Diseases of the heart and aorta / by Thomas E. Satterthwaite. Source: Wellcome Collection.

Provider: This material has been provided by the Augustus C. Long Health Sciences Library at Columbia University and Columbia University Libraries/Information Services, through the Medical Heritage Library. The original may be consulted at the the Augustus C. Long Health Sciences Library at Columbia University and Columbia University.

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    of the artery. Imleed, next to auscultation, the pulse is our most reliable aid in diagnosis. For freciuency, rhythm, rapidity and tension have each of them definite meanings. The frequent pulse occurs after brisk exercise, in fevers, alco- holism, hysterical conditions, phthisis and many other disor- ders. In heart diseases it also occurs during loss of compensa- tion : in the coffee and tobacco heart, and in cardiac neuroses; but it may be a coincidence rather than a symptom in heart dis ease. It is paroxysmal or chronic. It is also common in loco- motor ataxia. One of my patients suffering from tubercular phthisis with locomotor ataxia had for several years a pulse averag- ing between 120 and 130, and yet led a tolerably active busi- ness life. The greatest rapidity is seen in the paroxysmally fre- quent pulse, as in Graves disease. In the latter I have seen it reach 200 and upwards. In fact, in one of these cases, I could not count it, and I presume nothing short of the sphygmograph could have measured its frequency. There is also an hereditary element in the frequent pulse. On the other hand the infrequent pulse is often seen in cen- tral or peripheral nervous disturbances, toxaemias and wasting- affections ; sometimes in persons w^ith deficient vitality. It is> not very uncommon to have a pulse of 60 or even less, in chronic degenerative cardiac changes. Occasionally during a prolonged attack of heart failure, a pulse may remain continuously in the 30's for weeks at a time. I had such a case in 1900. Recovery ensued, at least so far as that the patient was able to go about and enjoy life much as before the attack. Then there is the pliysiologically infrequent pulse. Napoleon is said to have had' a pulse of 40. I saw a patient in 1901 w^ho had just suffered from an a]^oplectilorni attack. His pulse, also, was 40. Two years later when I examined him it was from 36—40. He was in fairly good condition. There has been no change since then, so far as I know. A patient I saw in 1903 with Dr. Swasey of New Britain,. Connecticut, has had a pulse of about 28 for the past year (1904). and at last accounts was attending to an active business, and had recently returned from a trip to Europe^ ■ In these cases it is important, however, to distinguish between the infrequent pulse due to infrequent cardiac action, or mere failure of the blood waves to reach the wrist. In a lady recently un- der my care, where the heart contractions averaged 80, only 30 pulse beats were felt at the wrist, when she first came under my observa-